Healthcare is often described as a sector characterized by resource shortages, high workloads, and structural challenges. At the same time, the understanding of these problems is shaped by organizational structures, governance, and the perspectives of different actors. Previous research has largely focused on identifying problems within healthcare, while less attention has been paid to how these problems are formulated and understood by different actors within the organization.

The aim of this study is to examine how problems within healthcare are understood and shaped by different actors within the organization. The study specifically focuses on how problems are constructed in relation to actors’ different positions and experiences within the organization.

The study is based on a qualitative research design in which semi-structured interviews were conducted with six participants from different parts of healthcare services, including assistant nurses, unit managers, and trade union representatives. The empirical material was analyzed using thematic analysis. The theoretical framework consists of organizational theory perspectives, New Public Management, Street-Level Bureaucracy, and theories of collaboration and responsibility allocation.

The findings show that organizational problems are not understood uniformly but are shaped differently depending on actors’ organizational positions, responsibilities, and experiences. Resource shortages, staffing issues, workload, organizational governance, and collaboration challenges emerged as recurring themes in the empirical material. The findings further indicate that organizational problems are rarely described as isolated phenomena, but rather as consequences of the interaction between organizational structures, governance systems, and the practical conditions of everyday work.

The study also demonstrates that organizational problems are closely linked to issues of power and legitimacy, where different actors have varying opportunities to influence which problems receive attention and which solutions are perceived as possible. The conclusion is therefore that organizational problems within politically governed healthcare cannot be understood as objective or neutral phenomena, but must instead be understood in relation to organizational structures, governance arrangements, and the perspectives of different actors.